Ramucirumab
An antibody that blocks the VEGF receptor, approved in liver cancer only for patients with a high AFP blood level, the first biomarker-selected HCC drug.
REACH-2: OS 8.5 vs 7.3 months in sorafenib-pretreated HCC with AFP ≥400 ng/mL (HR 0.71), after REACH failed in unselected patients. Also approved in gastric (RAINBOW), NSCLC (REVEL, with erlotinib in EGFR-mutant) and colorectal cancer (RAISE).
1.Ramucirumab binds VEGFR2 on blood-vessel cells
- Route
- Intravenous
- Schedule
- 8 mg/kg every 2 weeks
- Medicare
- Part B (clinician-administered)
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies.
- Commercial insurance
- covered with prior authorisation
Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments.
- Assistance programmes
- Lilly Cares Foundation
- PAN Foundation — Disease-specific co-pay and premium funds; open and closed funds change monthly.
- HealthWell Foundation
- CancerCare Co-Payment Assistance Foundation
- Patient Advocate Foundation Co-Pay Relief
20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
- Appraised for
- Advanced gastric or gastro-oesophageal junction cancer after chemotherapy
- Notes
- Also not recommended for NSCLC (TA403, 2016). HCC with high AFP appraised later. Not routinely available on the NHS.
Sources: NICE TA378. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2014 | Gastric cancer; NSCLC |
| US | 2019 | HCC with AFP ≥400 ng/mL after sorafenib |
| US | 2014 | Second-line advanced gastric/GEJ cancer alone or with paclitaxel |
| US | 2014 | NSCLC with docetaxel; 2015 mCRC with FOLFIRI; 2019 HCC AFP ≥400; 2020 EGFR-mutant NSCLC with erlotinib |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Hypertension | 25% | 13% |
| Proteinuria | 20% | 2% |
| Hypertension | — | — |
| Proteinuria | — | — |
| Bleeding/epistaxis | — | — |
| Neutropenia (with paclitaxel) | — | — |
REACH-2. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Landmark trials in OnCo
Latest papers
topQuery for this drug: (TITLE:"Ramucirumab" OR ABSTRACT:"Ramucirumab" OR TITLE:"Cyramza" OR ABSTRACT:"Cyramza") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Ramucirumab, not a curated reading list.
Pages like this
not linked directly; found by shared links- ProductBevacizumab (glioblastoma use)
Shares VEGF angiogenesis, Anti-angiogenic therapy, VEGF / VEGFR, Monoclonal antibodies.
- InstitutionOsaka International Cancer Institute
Shares Oesophageal cancer, Hepatocellular carcinoma, Gastric & gastro-oesophageal junction cancer, Colorectal cancer.
- TermHallmark: inducing or accessing vasculature
Shares VEGF angiogenesis, The angiogenic switch & tumour vessels, Anti-angiogenic therapy, VEGF / VEGFR.
- ProductRegorafenib
Shares The angiogenic switch & tumour vessels, Anti-angiogenic therapy, VEGF / VEGFR, Hepatocellular carcinoma.
- ProductFruquintinib
Shares The angiogenic switch & tumour vessels, Anti-angiogenic therapy, VEGF / VEGFR, Colorectal cancer.
- ProductPazopanib
Shares The angiogenic switch & tumour vessels, Anti-angiogenic therapy, VEGF / VEGFR.
- InstitutionTaipei Veterans General Hospital
Shares Hepatocellular carcinoma, Gastric & gastro-oesophageal junction cancer, Colorectal cancer, Non-small-cell lung cancer.
- PairingPD-1 blockade + VEGF inhibition
Shares VEGF angiogenesis, Anti-angiogenic therapy, Hepatocellular carcinoma, Non-small-cell lung cancer.